Krista Blyth-Gaeta, In-Home Supportive Services (IHSS) Program Director, provided an overview of the statewide implementation of the Electronic Visit Verification (EVV) system at the Tech Council’s July meeting. EVV is an electronic-based system that collects service delivery information including hours, location, type, and start/stop times of service. EVV will require Independent Providers (IPs) and IHSS clients to submit and approve timesheets online, and will eventually replace the current paper-based process. San Francisco has over 20,000 IHSS IPs and 22,000 IHSS Recipients.
Federal law, Subsection l of Section 1903 of the Social Security Act (42 U.S.C. 1396b), requires all states to implement EVV for Medicaid-funded personal care services by January 2020 and home health care services by January 2023. Federal penalties will result if States do not meet EVV requirements by the deadline. California alone faces an estimated $200 million penalty if it fails to comply. If individuals are not enrolled by that date, providers will not be paid and clients without care in place could be at significant risk from a loss of independence and safety.
EVV offers 2 ways for electronic data collection: through a secure website (can be accessed via mobile phone) or a telephone (land-based or mobile). The telephonic option has only been rolled out to clients for now. A provider telephone option is forthcoming. Between May and June 2019, outreach and communications has seen San Francisco enrollment (primarily through the website) increase from 20% to 25% for both providers and clients, which is still low in comparison to other large counties in California.
A challenge with meeting the deadline is that for the system to work effectively, both clients and providers have to enroll. For now, providers are more likely to enroll. Other challenges with enrollment in San Francisco are that a large proportion of the population is Cantonese-speaking, whereas the State system only provides information in Mandarin, and a significant proportion of the client population includes individuals with behavioral health issues. With increased outreach and marketing, telephonic use for enrollment is expected to increase for clients.
To plan outreach efforts, a literature review of behavioral economics was conducted to inform strategies for framing motivational messaging for clients to enroll as well as conducting follow up. IHSS also launched a home visit pilot on July 1st with 10 social workers to provide insights on the current level of awareness as well as challenges that people have with enrollment. Early insights from pilot indicate that a majority of clients need hands-on support despite being aware that paper timesheets are going away because they often didn’t know how to or have access to a computer or smartphone.
For more information about EVV and the current status of enrollment please visit the State website, as well as consult the following schedule to register and attend one of the online training webinars for providers and registers. To support EVV outreach and implementation in San Francisco, please contact Krista Blyth-Gaeta (firstname.lastname@example.org), IHSS Program Director, or Hugh Wang (Hugh.Wang@sfgov.org), IHSS Manager.